http://journals.lww.com/anesthesia-analgesia/pages/collectiondetails.aspx?TopicalCollectionId=113
en-usTue, 03 Mar 2015 13:30:33 -0600Wolters Kluwer Health RSS Generatorhttp://images.journals.lww.com/anesthesia-analgesia/XLargeThumb.00000539-201503000-00000.CV.jpeghttp://journals.lww.com/anesthesia-analgesia/pages/collectiondetails.aspx?TopicalCollectionId=113
http://journals.lww.com/anesthesia-analgesia/Fulltext/2014/06000/Enteral_Hydration_Prior_to_Surgery___The_Benefits.5.aspx
No abstract available]]>Sat, 24 May 2014 09:10:11 GMT-05:0000000539-201406000-00005http://journals.lww.com/anesthesia-analgesia/Fulltext/2014/06000/The_Effects_on_Gastric_Emptying_and_Carbohydrate.17.aspx
BACKGROUND: Preoperative administration of clear fluids by mouth has recently been endorsed as a way to improve postoperative outcomes. A carbohydrate-containing beverage supplemented with electrolytes or proteins may have additional benefits for patients’ satisfaction. However, effects on gastric residual, nausea, and emesis and the effectiveness of these beverages for improving patients’ hydration status have not been well defined.
METHODS: We evaluated changes in gastric volume over time by magnetic resonance imaging, as well as blood glucose levels, before and after administration of 500 mL oral rehydration solution (ORS) containing 1.8% glucose and electrolytes in 10 healthy volunteers. The same volume of an oral nutritional supplement (ONS) containing 18% glucose and supplemental arginine (545 mOsm/kg) was given to the same population using a crossover design.
RESULTS: The mean (median, 95% confidence interval) gastric fluid volume at 1 hour after oral ingestion was 55.0 (55.3, 39.0–70.9) mL in the ORS group, whereas 409.2 (410.9, 371.4–447.0) mL in the ONS group (P = 0.0002). The gastric fluid volume of all participants in the ORS group returned to <1 mL/kg at 90 minutes after ingestion, whereas none reached <1 mL/kg at 120 minutes in the ONS group. The ONS group showed a sustained increase in the blood glucose level after ingestion (P < 0.0001 to baseline at 30, 60, 120 minutes), while the ORS group showed an initial increase (P < 0.0001, P = 0.01, P = 0.205 at each time point).
CONCLUSIONS: ORS supplemented with a small amount of glucose showed faster gastric emptying, which may make it suitable for preoperative administration. In contrast, ONS supplemented with arginine with a relatively low osmolality was associated with a longer time for gastric emptying, although it showed a sustained increase in blood glucose level.]]>Sat, 24 May 2014 09:10:38 GMT-05:0000000539-201406000-00017http://journals.lww.com/anesthesia-analgesia/Fulltext/2014/06000/Dehydration_Enhances_Pain_Evoked_Activation_in_the.23.aspx
BACKGROUND: Negative effects of dehydration on the human brain and cognitive function have been reported. In this study, we examined the effects of dehydration on pain thresholds and cortical activations in response to pain, compared with rehydration with an oral rehydration solution (ORS) by functional magnetic resonance imaging.
METHODS: Five healthy adult men were subjected to dehydration and rehydration on 2 different days. The condition on the first day was randomly assigned to each subject. They completed a 40-minute exercise protocol using a walking machine after 12 hours of fasting under both conditions. For rehydration, the subjects consumed up to 3000 mL ORS starting from the night before the test day. After exercise, a painful stimulus (cold pressor test) was applied to the subjects’ medial forearm in a magnetic resonance imaging scanning gantry, and pain-evoked brain activation was analyzed.
RESULTS: On the rehydration day, each of the subjects consumed an average of 2040 mL (range; 1800–2500 mL) ORS. Physiological data revealed that subjects when dehydrated lost more weight from exercise than subjects when rehydrated had a larger heart rate increase, a higher tympanic temperature, and a higher urine osmolality. Subjective data revealed that the subjects reported significantly stronger thirst while dehydrated than while rehydrated with ORS, although the levels of hunger and anxiety and mood did not significantly differ between conditions. The cold pressor test robustly activated the pain-related neural network, notably the anterior cingulate cortex, insula, and thalamus. Such activations in the dehydrated subjects were greater than those in the rehydrated subjects in terms of peak and cluster, accompanied by a decrease in pain threshold (P = 0.001).
CONCLUSION: Our findings suggest that dehydration brings about increased brain activity related to painful stimuli together with enhanced thirst, whereas rehydration with ORS alleviates thirst and decreases brain activity related to painful stimuli.]]>Sat, 24 May 2014 09:11:07 GMT-05:0000000539-201406000-00023